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Longitudinal prescribing patterns in a nursing home population
S J Wayne1, R L Rhyne, M Stratton
1Department of Family, Community, and Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131.
Journal of the American Geriatrics Society
|January 1, 1992
Summary
Nursing home residents received more medications over time, particularly as-needed (PRN) prescriptions. This study analyzed patient characteristics and medication changes during the first three months of nursing home care.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Health Services Research
Background:
- Medication management in nursing homes is complex.
- Understanding prescribing patterns is crucial for patient safety.
Purpose of the Study:
- To document patient characteristics associated with initial medication prescriptions in nursing homes.
- To analyze changes in medication prescribing patterns within the first three months of residency.
Main Methods:
- A one-year admission cohort study was conducted in three university-affiliated nursing homes.
- Data included patient demographics, functional status, mental status, diagnoses, and prescribed medications (scheduled and PRN) at admission and three months.
- Eighty-one new admissions were analyzed.
Main Results:
- Older patients and women received fewer scheduled medications. A positive association was found between the number of diagnoses and scheduled medications.
- No significant associations were observed between prescribed medications and mental status or functional level.
- The average total number of medications increased significantly from 4.7 at admission to 6.2 at three months, driven by a rise in PRN medications.
Conclusions:
- Medication prescribing patterns differ between scheduled and PRN categories in nursing home residents.
- Consistent monitoring points are valuable for assessing medication use in this population.
- Distinguishing between PRN and scheduled medications is essential for future research.